Medicine and Health Sciences Commons^™

Moral Competence In Nursing: An Exploration Of The Giving Voice To Values Curriculum, Catherine Costa

Theses

The development of moral competence is central to the profession of nursing and its practice. Nurses engage in moral decision making that impacts the health of people, families, and communities. It is important, then, to ensure that nursing graduates possess the necessary moral development for engaging in professional practice. To this end, research was conducted, the principle premise of which was to explore the use of the introduction of the Giving Voice to Values curriculum (Gentile, 2010) and its contribution to the development of moral competence in nursing. The Giving Voice to Values curriculum is a values-based methodology enabling students …

Understanding Falls In People With Intellectual Disability In Western Australia, Portia Ho

Theses

Adults with intellectual disability (ID) experience earlier age-related changes, compared with other age-matched populations, but concurrently their life expectancy is increasing. Falls often result in serious injuries and reduced health-related quality of life, however there is limited research regarding falls in older adults with ID. The purpose of this research was to investigate falls among community dwelling older adults with ID, including the epidemiology, risk factors and experiences when engaging with health services after a fall.

A meta-analysis of the incidence and prevalence of falls in adults with ID was initially conducted to inform the research aims. Prospective research was …

Exploring The Validity Of Script Concordance Testing To Assess The Clinical Reasoning Of Medical Students, Micahel Sh Wan

Theses

Assessment of clinical reasoning is often challenging, as it is a complex process of thinking and decision making. Script Concordance Testing (SCT), using authentic clinical scenarios with diagnostic or management uncertainties, has been developed to assess clinical reasoning. As SCT is a relatively new assessment modality, more empirical evidence is needed to support the validity of SCT scores.

This thesis examines key aspects of the validity of SCT scores in the assessment of the clinical reasoning ability of medical undergraduates. A review of the current literature informs the use, design and standard setting of SCT, as well as evidence for …

The Importance Of Environmental Interventions In Eliminating Trachoma Infection In Africa: The Case Of Gashoho Health District, Burundi, Desire Ndisabiye

Theses

Gashoho Health District, Burundi, has not achieved the World Health Organisation (WHO) target of elimination of the blinding infectious disease, trachoma, by 2020. The work in this thesis addresses this problem using three different approaches.

Firstly, a cross-sectional study was undertaken to establish the current trachoma prevalence in Gashoho and whether poor sanitation was a risk factor for infection. 468 individuals from 117 households across four villages were clinically examined for signs of trachoma infection, and completed a questionnaire about environmental risk factors. The current prevalence of trachoma in Gashoho was 7.9% (95 % CI 5.0 - 10.6%). Children under …

Early Post-Operative Rises In Serum Metal Ion Levels In Total Hip Arthroplasty: A Prospective Cohort Study, Michael Le

Theses

Background: Serum Cobalt (Co) and Chromium (Cr) forms part of the diagnostic process for metallosis following Total Hip Arthroplasty (THA). While knowledge exists on longer term metal ion levels, expected early post-operative rises in serum Co and Cr in Metal-on-Polyethylene (MoP) THAs are currently unknown. This study aims to describe early rises in serum Co and Cr at 6 months post-operatively.

Methods: A prospective cohort study of 84 consecutive patients with an uncemented titanium stem from a single THA manufacturer was performed. Patients had either a metal (n=43) or ceramic (n=41) head articulating with a highly cross-linked polyethylene. Serum Co …

Asthma-Copd Overlap: Economic Burden And Medication Adherence, Mona Nili

Graduate Theses, Dissertations, and Problem Reports (ETD)

In many older adults, asthma and chronic obstructive pulmonary disease (COPD) coexist as “Asthma-COPD overlap” (ACO). This dissertation pursued three Aims: 1) estimate the economic burden of ACO and its contributory factors; 2) evaluate the association of ACO to “cost-related medication nonadherence” (CRN); and 3) identify adherence trajectory patterns and examine the impact of initial maintenance therapies (IMT) type (inhaled corticosteroids monotherapy (ICS) vs. fixed-dose combination of ICS and long-acting beta agonist (ICS/LABA)) on adherence trajectory patterns among older adults Medicare Beneficiaries. The first and second Aims were cross-sectional studies by using Medicare Current Beneficiary Survey data. For the third …

Evaluation Of The Impact Of An Educational Intervention Aimed At Improving Tuberculosis Infection Control Knowledge Among Health Care Workers In A Military Treatment Facility: A Quality Improvement Project, Allen C. Potter

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Florida (FL) is one of the top five states in the nation for Tuberculosis (TB) infections. A majority of new infections can be found in the minority populations which represents 78% of all TB infections in the state. A combination of TB rates in FL, Orlando located 60 miles away and a transient population who frequently deploys worldwide to austere locations may result in an increased risk of acquiring TB. Literature suggests Health Care Providers (HCPs) obtain training regarding TB Infection Control (TB-IC). The Patrick AFB Military Treatment Facility (MTF) lacked a TB Infection Control (TB-IC) plan. Objective: The …

Creating A Community-Based Protocol To Prevent Unintended Pregnancy In Homeless Women In Monongalia County, West Virginia, Jessica Eva Wukasch

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: At any given time, 10% of homeless women are pregnant, about twice the rate of all U.S. women of reproductive age (5%) (Healthcare for the Homeless, 2001). According to Healthcare for the Homeless Council ([HHC], 2012), approximately “73% of pregnancies among homeless women were unintended at the time of conception.” In addition, “about 12% of homeless children are placed in foster care compared to 1% of other children” (HHC, 2012). There is an evident need to address unintended pregnancy among homeless women.

Objective: The overall objective was to create an accessible and useful community-based protocol to reduce the rate …

Evaluation Of Control Strategies For Overhead Work Using Electromyography Of Rotator Cuff Muscles, Hossein Motabar

Graduate Theses, Dissertations, and Problem Reports (ETD)

Work-related musculoskeletal disorders (MSDs) of shoulder have a significant impact on overall health and economics in the industrialized nations. Rotator cuff is the most frequently injured region in the shoulder complex. Overhead work is considered as one of the most predominant causes of rotator cuff injuries. The workers in construction, automotive, and aerospace industries are routinely exposed to overhead exertions. Elimination of overhead work is nearly impossible due to various task and technology constraints. Therefore, appropriate intervention strategies based on the engineering and administrative controls opt to be used to prevent the hazardous impact of overhead exertions. The objective of …

Evaluation Of The Care And Communication Bundle To Improve Palliative Care In Intensive Care Units, Angela Susan Bohon

Graduate Theses, Dissertations, and Problem Reports (ETD)

Review of local data and concerns from nursing staff revealed the need to improve palliative care in a local, community hospital Intensive Care Unit (ICU). This effort was mobilized by implementing the Care and Communication Bundle within evidence-based time frames, into this local, community ICU, using Lewin’s Change theory as a guide for implementation. The Care and Communication Bundle is a grouping of nine palliative, quality measures found to improve palliative care in the ICU. A pre/post-educational intervention evaluated if the implementation of the Care and Communication Bundle in the ICU improved palliative care by reviewing the documentation of the …

Three Essays On Health Economics And Policy Evaluation, Shishir Shakya

Graduate Theses, Dissertations, and Problem Reports (ETD)

This dissertation consists of three essays on the U.S. Health care policy. Each paragraph below refers to the three abstracts for the three chapters in this dissertation, respectively. I provide quantitative evidence on how much Prescription Drug Monitoring Programs (PDMPs) affects the retail opioid prescribing behaviors. Using the American Community Survey (ACS), I retrieve county-level high dimensional panel data set from 2010 to 2017. I employ three separate identification strategies: difference-in-difference, double selection post-LASSO, and spatial difference-in-difference. I compare how the retail opioid prescribing behaviors of counties, that are mandatory for prescribers to check the PDMP before prescribing controlled substances …

Evidence Of Y Chromosome Long Non-Coding Rnas Involved In The Radiation Response Of Male Non-Small Cell Lung Cancer Cells, Tayvia Brownmiller

Graduate Theses, Dissertations, and Problem Reports (ETD)

Non-small cell lung cancer (NSCLC) is the number one cause of cancer related mortality in the United States and worldwide. Advanced and therapeutically resistant lung tumors contribute to the high rate of mortality from NSCLC, therefore there is a need for new methods of diagnosing and treating this disease. Long non-coding RNAs (lncRNAs) have been shown to be a crucial component of human molecular biology, regulating nearly every cellular pathway from chromatin condensation to transcription and translation. Furthermore, many lncRNAs have been classified as oncogenes or tumor suppressors, highlighting the various molecular mechanisms they are involved in regarding the formation …

Comparison Of Skeletal And Dentoalveolar Changes Between Two Bone-Borne Maxillary Expanders, Mohamad Sarraj

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Bone-borne maxillary expander (BBME) are designed to provide additional anchorage to widen the maxillary arch for patients who exhibit maxillary transverse deficiency. One form of BBME is the hybrid BBME which uses mini-implants (bone-borne) and posterior teeth (tooth-borne) as anchorage for maxillary expansion. The other form of BBME is absolute BBME which only uses mini-implants as anchorage. It is not clear in the literature if there is a difference in skeletal and dental changes with these two types of expanders. The objective of this study was to compare the skeletal, dentoalveolar, and periodontal changes between the hybrid and the …

Integrating The Natural Healing Process For Post-Traumatic Stress Disorder Treatment In Veterans Through A Healing Garden., Taiwo A. Ajibade

Graduate Theses, Dissertations, and Problem Reports (ETD)

In 2002, several ex-service personnel brought a court case against the Ministry of Defense for the inability to identify PTSD issues at an early stage and to provide support and effective treatment (Langston et al. 2007). Also in recent times, reports have suggested that US marine and army infantry units returning from duty in Iraq and Afghanistan have a higher level of expected proportions of mental disorders and that about 10% of personnel are returning home are with symptoms of post-traumatic stress disorder (Smith et al., 2008). This discovery made it pertinent to look for natural ways to assist veterans …

Association Of Common Chronic Pain Conditions To Incident Alzheimer’S Disease And Related Dementias In Two Cohorts Of Older Medicare Beneficiaries, Sumaira Khalid

Graduate Theses, Dissertations, and Problem Reports (ETD)

Objective: The purpose of this research was to study the collective and incremental association of common non-cancer chronic pain conditions (NCPC) to risk for Alzheimer’s disease and related dementias (ADRD); to explore the potential mediating influence of mood and sleep disorders; and to assess the potential synergistic effects of NCPC’s and multimorbidity on ADRD risk. This research also aimed to study the contribution of NCPC to ADRD risk in poor, rural, underserved United States populations who suffer a disproportionate burden of ADRD risk factors. To achieve these goals, this dissertation pursued three specific aims: 1) assess the association of …

Structural Transformations Of Synaptic Partners During Growth And Competition Of The Giant Nerve Terminal, The Calyx Of Held, In The Medial Nucleus Of The Trapezoid Body In The Developing Postnatal Mouse, Dakota Richard Jackson

Graduate Theses, Dissertations, and Problem Reports (ETD)

Across many parts of the nervous system, initial neural circuit assembly involves stereotyped stages of early axonal proliferation within target territories, selective reinforcement of a subset of inputs and the removal of exuberant or unneeded connections via either activity or experience-dependent mechanisms, in a process referred to as synaptic competition. The mechanisms and associated structural transformations that underlie and define these stages of neurodevelopment have been examined in a variety of brain regions including the peripheral neuromuscular junction, the central climbing fiber innervation of cerebellar Purkinje cells and retinal ganglion cell innervation of the thalamic lateral geniculate nucleus. Each of …

Pilot Study Of Behavioral Activation As Adjunct Treatment For Depression In Primary Care, Lindsay Ellen Toler

Graduate Theses, Dissertations, and Problem Reports (ETD)

Many individuals receiving care at a predominantly free primary health care clinic in the northern part of West Virginia are experiencing depression, and medication therapy is the most common form of management with limited resources for psychosocial treatment. Brief psychosocial therapy interventions provided by the primary care provider should be explored as an adjunct treatment for this population in the primary care setting.

A pilot study was conducted to explore the integration of behavioral activation, a brief psychosocial intervention focused on decreasing depressed behavior by increasing nondepressed behavior to reinforce corresponding improvements in mood. Eligible patients were invited to attend …

Understanding The Host Immune Response Against Pseudomonas Aeruginosa To Develop Novel Therapeutics And Vaccines, Emel Sen Kilic

Graduate Theses, Dissertations, and Problem Reports (ETD)

Pseudomonas aeruginosa is a Gram-negative opportunistic bacterium that causes a broad range of acute and chronic infections. The high adaptability and emergence of multidrug-resistant strains of this bacterium pose a significant threat to human health. Particularly, pneumonia caused by this pathogen is associated with high morbidity and mortality in immunocompromised patients. To prevent these infections, we aimed to develop novel vaccine strategies by characterizing the host immune response against P. aeruginosa. During respiratory infections, P. aeruginosa first contacts with epithelial cells along the respiratory tract. Using RNA-sequencing, we were able to characterize transcriptional changes of the epithelial cells in …

Wv Dental Hygienists' Knowledge And Educational Approach For Pregnant Women, Isabella Hope Mcdaniel

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Adverse pregnancy outcomes have become a concern for dental professionals caring for pregnant women with poor oral health. Pregnant women may not be aware of their increased risk of bacterial infections in their oral tissues and how it could relate to adverse pregnancy outcomes such as pre- term birth (PTB) and low birthweight babies (LBW). Dental healthcare professionals need to be well informed of risk related to poor oral health and have confidence to effectively educate pregnant women. PTB and LBW babies account for 1 million infant deaths annually. It is the responsibility of dental healthcare professionals to be …

Health Outcomes Associated With Gulf War Illness, Shannon K. Barth

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background:

Nearlythirty years after the 1990-1991 Persian Gulf War a definitive case definition for Gulf War Illness (GWI) is lacking. The objective is to explore health outcomes associated with GWI using currently accepted classifications in order to better understand GWI by examining pre-war medical conditions as predictors of probable GWI, mortality outcomes of veterans with probable GWI, and female-specific medical conditions among women with probable GWI. Additionally, we utilize an alternative GWI case definition.

Methods:

Data come from theDepartment of Veterans Affairs (VA)1995-1997 National Health Survey of Persian Gulf War Era Veterans, a population-based survey of deployed …

Cerebrovascular Dysfunction And Degeneration In Alzheimer’S Disease Pathophysiology, Dominic Dimitri Quintana

Graduate Theses, Dissertations, and Problem Reports (ETD)

Alzheimer’s disease (AD) is a terminal illness and the most common form of dementia, which disproportionately affects the aged population. The pathophysiology of AD is characterized by neurodegeneration that slowly progresses, affecting regions of the brain that are involved in learning, memory, language, and executive function. In patients with the disease, early symptoms include non-disruptive forgetfulness that evolves into the inability to form new memories and ultimately the loss of autonomy at late stages. Histopathological hallmarks in the brain from patients with AD is the presence of amyloid-β (Aβ)-plaques and neurofibrillary tangles (NFT) deposited in the parenchyma. Since the discovery …

Performance Study Of Five Different Cabin Air Filters In The Laboratory And On-Road Drive, Fahad Alqahtani

Graduate Theses, Dissertations, and Problem Reports (ETD)

One of the aims of installing ventilation filters in a car is to prevent vehicle occupants from inhaling potentially harmful aerosols emanating from the environment. Vehicle cabin filters are essential in ensuring that a vehicle's air conditioning system provides clean air to its occupants. The purpose of the cabin filter is to improve air quality inside the car to provide better comfort and better protect occupants from experiencing unwanted respiratory problems. Using cabin filters in air conditioning systems is a common practice in modern vehicle manufacturing. Scientists and engineers are continually seeking new ways of improving the efficiency and effectiveness …

Effect Of Western Diet And Caloric Substitution With Apple Pomace On Fatty Acid Composition And Gene Expression In The Hypothalamus Of Growing Female Sprague-Dawley Rats, Ayad Abdulhamid Alawadi

Graduate Theses, Dissertations, and Problem Reports (ETD)

The hypothalamus plays a major role in regulating food-intake and energy-expenditure. Hypothalamic dysfunction implicated in neurodegenerative diseases is characterized by diet-induced neuroinflammation and energy dysregulation. Apple pomace, a waste byproduct of processing, is rich in polyphenols and soluble fibers, has the potential to ameliorate diet-inducing inflammation. The objective of this study was to determine the effects of Western diet and caloric substitution of Western diet with 10% apple pomace on brain fatty acid composition and gene expression related to hypothalamic function and health in growing female rats. Growing female Sprague-Dawley rats (age 22-29 days) were randomly assigned (n=8 rats/group) to …

The Pattern Of Odontogenic Referred Pain, James J. Poulos

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Referred odontogenic pain (RP) is a phenomenon that is seen regularly in dentistry and it is not extensively understood. It can make formulating a proper diagnosis difficult and its presence can lead to inappropriate treatment.

Methods: 250 patients experiencing odontogenic pain within the dental clinics of West Virginia University were surveyed. The survey inquired about the patient’s biographical information, medical history, characteristics of the pain, the presence and location of RP, and the psychosocial effects of the pain. Additionally, the endodontic diagnosis of the offending tooth was determined by a member of the endodontic department. The collected …

The Interplay Of Progestins, Matrix Metalloproteinases, And The Aging Brain, Keyana Nicole Porter

Graduate Theses, Dissertations, and Problem Reports (ETD)

Progestins are synthetic hormones that are designed to mimic the biological actions of progesterone. They, however, possess other pharmacological actions and properties, in addition to their progestational activities. Medroxyprogesterone Acetate (MPA) is a progestin used globally in the hormonal contraceptive, Depo Provera®, by women in their reproductive prime and is a major compound found in hormone therapy (HT) formulations used by menopausal women. MPA is used by approximately 1 in 5 adolescents and adult women in the United States who are sexually active. Globally, nearly 48 million women utilize injectable contraceptives to prevent pregnancy, with most users utilizing MPA as …

Green Completion As A Mitigation For Btex Exposure In Gas Flaring: Nigeria Case Study (Exposure Assessment And Cost Model), Akintunde S. Akinyemi

Graduate Theses, Dissertations, and Problem Reports (ETD)

Gas flaring is an essential part of the oil and gas industry safety and waste management procedures; however, it presents a potential exposure to BTEX compounds, a group of Non-Methane Volatile Organic Compounds (NMVOC), within up to a 10-mile radius of the flare point. The physical and the psychological cost of the journey to work, make employees live close to the workplace. This study examined the perceived exposure of oil and gas industry workers to possible carcinogenic emissions outside the workplace. It looked at the outcomes of the exposure to BTEX through gas flaring drawing on archival data and using …

Applications Of Machine Learning Methods In Health Outcomes Research: Heart Failure In Women, Khalid Abdullah Alhussain

Graduate Theses, Dissertations, and Problem Reports (ETD)

There is robust evidence that heart failure (HF) is associated with substantial mortality, morbidity, poor health-related quality of life, healthcare utilization, and economic burden. Previous research has revealed that there are sex differences in the epidemiology, etiology, and disease burden of HF. However, research on HF among women, especially postmenopausal women, is limited. To fill the knowledge gap, the three related aims of this dissertation were to: (1) identify knowledge gaps in HF research among women, especially postmenopausal women, using unsupervised machine learning methods and big data (i.e., articles published in PubMed); (2) identify emerging predictors (i.e., polypharmacy and some …

The Use Of Differing Verb Types In The Oral Narratives Of School-Age Children, Allison Ann Switzer

Graduate Theses, Dissertations, and Problem Reports (ETD)

The aim of this project was to examine the use of action, metacognitive, and metalinguistic verbs in narratives relative to age-related growth for children with typical language and their peers with a language-based disorder. While limited information is known about the use of these differing verb types, there is evidence to show that metacognitive and metalinguistic verbs are less salient than action verbs, and therefore have a longer trajectory of acquisition. The oral narratives of 84 typically developing students were coded for occurrences of action verbs, metacognitive verbs, and metalinguistic verbs to obtain a total use as well as to …

Will Pitch Velocity Remain Consistent Throughout A Competitive Baseball Season Following Blood Flow Restriction: An Observational Study, Mackenzie Marie Evans

Graduate Theses, Dissertations, and Problem Reports (ETD)

Context: Blood flow restriction (BFR) has previously been used in a rehabilitation setting to decrease the external load applied to post-surgical patients and those with chronic debilitating conditions. BFR in a performance context has been explored minimally, particularly as it applies to baseball pitching over time. Objective: The purpose of this study was to retrospectively investigate the trend in throwing velocity of fastballs with BFR implementation over one competitive season. Design: This study was a retrospective longitudinal design on pitching velocity of fastballs throughout a competitive season. Setting: The data collection and analysis was completed at …

The Effects Of Acute Photobiomodulation On Anaerobic Exercise Performance, Jillian Danielle Forsey

Graduate Theses, Dissertations, and Problem Reports (ETD)

Optimal performance in sport requires a balance between training stress and recovery. Therapeutic modalities that allow athletes to maintain this balance while training hard are in high demand, but many lack research. Photobiomodulation is a red and near-infrared light therapy that is proposed to enhance exercise performance and hasten recovery. The purpose of this study was to examine the effects of acute whole body photobiomodulation, applied pre-exercise, on anaerobic exercise performance.

Forty-eight healthy, active subjects participated in this single-blind, crossover study. Subjects visited the lab three times to complete a repeat Wingate test, with one week between each visit. All …